Home Drug Guide Labetalol Hydrochloride

Drug Guide

Generic Name

Labetalol Hydrochloride

Brand Names Normodyne, Trandate, Labetalol Hydrochloride In Dextrose, Labetalol Hydrochloride In Sodium Chloride

Classification

Therapeutic: Antihypertensive

Pharmacological: Beta-adrenergic blocker with alpha-1 blocker activity

FDA Approved Indications

  • Management of hypertension

Mechanism of Action

Labetalol is a non-selective beta-adrenergic antagonist with alpha-1 adrenergic blocking activity, which causes vasodilation and decreases blood pressure by reducing heart rate and peripheral resistance.

Dosage and Administration

Adult: Initial dose typically 100 mg twice daily, titrated based on response. Maximum dose may be up to 2400 mg/day in divided doses.

Pediatric: Not commonly used in pediatric populations; consult specific guidelines.

Geriatric: Dose adjustments may be necessary based on renal and hepatic function; start at lower doses.

Renal Impairment: Use caution; may require dose adjustment and monitoring.

Hepatic Impairment: Use with caution; hepatic function should be monitored.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Extensively metabolized in the liver.

Excretion: Excreted in urine and bile.

Half Life: 3 to 6 hours.

Contraindications

  • Asthma or other bronchospastic conditions
  • Second- or third-degree heart block
  • Cardiogenic shock

Precautions

  • Use with caution in heart failure, renal impairment, hepatic impairment, and in patients with a history of depression. Monitor blood pressure, heart rate, and respiratory status regularly. Not recommended during pregnancy unless clearly needed; breastfeeding considerations should be discussed.

Adverse Reactions - Common

  • Fatigue (Common)
  • Dizziness (Common)
  • Nausea (Common)
  • Bradycardia (Less common)

Adverse Reactions - Serious

  • Severe hypotension (Rare)
  • Bronchospasm (Rare)
  • Liver function abnormalities (Rare)
  • Heart failure exacerbation (Rare)

Drug-Drug Interactions

  • Other antihypertensives, like calcium channel blockers, nitrates, diuretics, which may enhance hypotensive effects.
  • CYP2D6 inhibitors may affect the metabolism of labetalol.

Drug-Food Interactions

  • Alcohol may enhance hypotensive effects.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, respiratory status, and signs of heart failure.

Diagnoses:

  • Risk for ineffective tissue perfusion related to hypotension.
  • Impaired gas exchange related to bronchospasm.

Implementation: Administer with meals to decrease orthostatic hypotension. Titrate doses carefully and monitor patient response.

Evaluation: Assess blood pressure and heart rate regularly to evaluate therapeutic effect and adjust dosage accordingly.

Patient/Family Teaching

  • Instruct patient to take medication as prescribed and not to stop suddenly.
  • Warn about possible side effects like dizziness, fatigue, and bronchospasm.
  • Advise to rise slowly from sitting or lying position.
  • Inform about possible interactions with other medications and the importance of reporting all current medications.

Special Considerations

Black Box Warnings:

  • Use in caution in patients with asthma or other bronchospastic conditions.

Genetic Factors: CYP2D6 poor metabolizers may have increased plasma levels.

Lab Test Interference: May interfere with certain laboratory tests, including liver function tests.

Overdose Management

Signs/Symptoms: Severe hypotension, bradycardia, bronchospasm, loss of consciousness.

Treatment: Supportive care, IV fluids, atropine for bradycardia, vasopressors for hypotension, airway management as needed.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.